AMN Healthcare Revenue Cycle is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Palo Alto, California. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: 08/3...

Cross Country Nurses is seeking a travel nurse RN Utilization Review for a travel nursing job in Atlanta, Georgia. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: 08/24/2026 Duration: 21 weeks ...

AMN Healthcare Revenue Cycle is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Portland, Maine. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: 08/31/2026...

. Documentation and Reporting: Document findings from utilization reviews in the appropriate systems and ensure accurate record...

Responsibilities The Valley Health System has expanded into an integrated health network that serves more than two million people in Southern Nevada. Starting with in 1979, the Valley Health System has grown to include , , Benefit Highl...

How you'll contribute Utilization Review Specialist facilitates clinical reviews on all patient admissions and continued stays... organizations, external reviews, and other payers. Communicate with physicians to schedule peer to peer reviews. Accurately report...

prospective, concurrent, and retrospective drug utilization reviews. Evaluate prescribing patterns against clinical guidelines... recommendations for prescribers to optimize therapy and reduce risk. Document reviews and ensure compliance with state, federal...

. Provides technical assistance and support. Reviews programs, services, screens, and reports, and confers with management...

requirements and performance expectations. Perform prospective, concurrent, and retrospective utilization reviews and first-level... prospective, concurrent, and retrospective utilization reviews. Ability to conduct first-level determination approvals using BSC...

a minimum of four days per week. Primary Responsibilities: 30% 1b. Performs concurrent and retrospective reviews...

and book reviews are accurately edited, formatted, proofread, and published according to journal standards and deadlines...

permits; reviews and approves invoices and other documentation; facilitates project meetings; participates and recommends... for and administers grants; and prepares and distributes project updates. Prepares and/or reviews technical presentations, reports, land...

Description: In this role the Genetic Counselor will do the following: Perform pre service utilization reviews...

, and hospital policies. Actively participates in, Utilization Management Oversight Committees, audits, and regulatory reviews...

management activities for the Federal Employee Program. This role is responsible for conducting clinical reviews of prior... Perform pre-service utilization reviews and first-level determination approvals for members using evidence-based guidelines...

, and payers to support timely authorizations, concurrent reviews, and discharge planning while minimizing avoidable days... Conduct initial and concurrent chart reviews to confirm admission and continued stay meet level-of-care criteria Provide...

positive outcome and optimal reimbursement, through coordination of patient care, daily clinical reviews, quality documentation... reviews with all payer types (Managed Medicare, Managed Medicaid and commercial) to secure authorization for continued...

. Candidates must have a MD license from IL. JOB SUMMARY: Relying on clinical background, reviews health claims providing medical... Responsibilities: MAJOR DUTIES AND RESPONSIBILITIES: Reviews medical files and provides recommendations for utilization review, chart...

clinical reviews on all patient admissions and continued stays. UR analyzes patient records to determine legitimacy... appeals are completed thoroughly and on a timely basis. Interface with managed care organizations, external reviews...

to facilitate the effective management of contract attorneys including timesheet reconciliations, monitoring the pace of reviews...